Posted on March 29, 2016 by Bobby Gheorghiu
On average, 50 per cent of those with chronic diseases deviate from recommended treatment protocols, which can not only affect their health outcomes, but also cost the health care system (estimated at $300 billion annually in the U.S.).1 Over the past decade, Infoway has worked with our partners to investigate, pilot, evaluate and broadly deploy solutions which address health system challenges like these.
Recently, we contributed to an evaluation of one such promising technology. It’s a low-cost intervention, first introduced in Kenya in 2007, and uses simple text messages to foster better treatment adherence for patients with HIV. Given that more than 85 per cent of Canadians own a mobile phone, the program was subsequently introduced here as a pilot.
We engaged the University of British Columbia to conduct a benefits evaluation and economic analysis of the program. The result: a cost-effective, easy-to-use solution that improved patient adherence to treatment.
Using SMS (text) messaging technology, health care providers could monitor patients with chronic diseases, such as latent tuberculosis (TB) and HIV conditions, remotely. A weekly check-in text message was sent to participants who were expected to text back their status within 48 hours. A problem response (e.g., “Not feeling well.”) was triaged to the appropriate health care provider for follow up, and a non-response received a follow-up text. Simple language was used to minimize challenges for participants who speak English as a second language.
The report revealed that:
- Participants found the program easy to use and understand
- Participants appreciated the support and being connected to someone
- Healthcare providers felt the platform was efficient and delivered patient-centred care, while enhancing communication with patients
- The program, with costs of $115 per patient per year, helped manage human resource costs:
- One nurse managed 85 highly vulnerable HIV positive clients and spent two hours per week responding to messages
This is another example of digital health making a difference. It also demonstrates that a solution doesn’t need to be complicated or expensive to be effective. Learn more in the report summary.
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1Balkrishnan R. The importance of medication adherence in improving chronic-disease related outcomes: what we know and what we need to further know. Med Care. 2005;43(6):517-520. See more at: http://www.ajmc.com/journals/issue/2010/2010-12-vol16-n12/ajmc_10dec_gatwood_925to926#sthash.76vRsAOh.dpuf
Bobby works with stakeholders in academia, private and public sectors to develop and monitor performance targets for initiatives such as PrescribeIT®, Canada’s national e-prescribing service, to ensure widespread adoption of technology and to demonstrate tangible benefits of investments in digital health. He holds an MHSc in Health Policy, Management, and Evaluation from the University of Toronto.